McKittrick-Wheelock syndrome: a rare cause of diarrhoea.

McKittrick-Wheelock syndrome is a rare disorder caused by fluid and electrolyte hypersecretion from a rectal tumour. The most frequently reported tumours are villous adenomas. Dehydration with severe hyponatremia, hypokalemia, metabolic acidosis, acute renal failure and watery diarrhoea is typical. The authors present a case of McKittrick-Wheelock syndrome caused by rectal adenocarcinoma.

Anti-ganglioside antibodies-mediated leptospiral meningomyeloencephalopolyneuritis.

A case of leptospirosis complicated with meningo-myelo-encephalo-polyneuritis and nephrotic syndrome is presented. Anti-ganglioside antibodies were detected for the first time in a patient with neurological complications of leptospirosis. Possible pathogenic mechanisms and treatment options of these rare manifestations are discussed.

Chlamydia pneumoniae infection as a trigger for a Cogan's syndrome.

Cogan's syndrome is often preceded by upper respiratory tract symptoms. The only reported specific agent possibly involved in pathogenesis of the Cogan's syndrome was Chlamydia pneumoniae. Positive IgA, IgM and IgG antibodies against C. pneumoniae in our patient suggest possibility of Chlamydia's role as a trigger for the vasculitis.

Idiopathic Cd4+T-lymphocytopenia--two unusual patients with cryptococcal meningitis.

Idiopathic CD4+T-lymphocytopenia (ICL) is a syndrome characterised by the depletion in the CD4+T-cells but without evidence of HIV infection. Aside from low CD4+lymphocyte counts, the immunologic findings in these patients are distinct from the abnormalities found in HIV infection. There are numerous reports of ICL associated with different diseases and clinical conditions. Opportunistic infections, mostly seen in HIV patients are the most common among them. We describe two patients without risk factors for human immunodeficiency virus (HIV) infection, each of whom presented with cryptococcal meningitis and was found to have idiopathic CD4+T-lymphocytopenia. One of them also acquired EBV and CMV coinfection of the central nervous system.

Atypical Cogan's syndrome mimicking encephalitis.

Cogan's syndrome is a rare autoimmune multisystem disease. The main clinical features of typical Cogan's syndrome are vestibuloauditory dysfunction and interstitial keratitis. The authors present a case of atypical Cogan's syndrome with headache, fever, deafness, trigeminal neuralgia and electroencephalographic abnormality which mimicked viral encephalitis.